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Nguyen AJ, Johnson E, Camilleri M, Wieland C, Lehman JS, Agrawal S, Comfere N, Fadra N, Knudson RA, Greipp P, Halling K, Ray Guo R. Ancillary immunohistochemical and molecular testing in the classification of cutaneous sweat gland/duct neoplasms: A validation study with emphasis on histomorphologic correlation and pathological diagnosis. Hum Pathol 2024; 150:1-8. [PMID: 38876201 DOI: 10.1016/j.humpath.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/09/2024] [Accepted: 06/11/2024] [Indexed: 06/16/2024]
Abstract
Sweat gland neoplasms represent a challenging area of dermatopathology, as they are relatively uncommon and often histopathologically complex. Recent studies have uncovered distinct immunohistochemical and molecular profiles in several sweat gland neoplasms, including digital papillary adenocarcinoma (DPA), papillary eccrine adenoma/tubular apocrine adenoma (PEA/TAA), poroid family tumors (PFT)/porocarcinoma, and clear cell hidradenoma (CCH)/clear cell hidradenocarcinoma (CCHCa). To further evaluate the diagnostic utility of ancillary studies in various sweat gland neoplasms, we performed an independent validation study in a cohort of patients with acral and non-acral tumors (9 DPA, 8 PEA/TAA, 13 PFT, 5 porocarcinoma, 23 CCH, 7 CCHCa, 6 sweat gland carcinoma not otherwise specified). p63 immunohistochemistry (IHC) demonstrated a myoepithelial pattern in 8/8 DPA and 4 of 4 tested PEA/TAA cases, and showed a ductal pattern in all tested PFT/porocarcinoma and CCH/CCHCa cases (42/42). All PEA/TAA (8/8) cases were positive for BRAF V600E IHC. 5 of 12 tested PFT and 5/5 porocarcinoma cases showed either positive staining with NUT IHC or harbored YAP1::NUTM1 fusion gene by RNA sequencing. MAML2 fluorescence in situ hybridization (FISH) was positive in all CCH and CCHCa cases (23/23 and 7/7, respectively). Our results further support the usefulness of appropriate ancillary studies in precise classification of sweat gland tumors, which may be routinely applied in diagnostic pathology practice when morphologic evaluation is in doubt.
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Affiliation(s)
- Amanda J Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Emma Johnson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Michael Camilleri
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Carilyn Wieland
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Julia S Lehman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Shruti Agrawal
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Nneka Comfere
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Numrah Fadra
- Division of Computational Biology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Ryan A Knudson
- Cytogenetics Core Laboratory, Mayo Clinic, Rochester, MN, 55905, USA
| | - Patricia Greipp
- Division of Laboratory of Genetics and Genomics, Mayo Clinic, Rochester, MN, 55905, USA
| | - Kevin Halling
- Division of Laboratory of Genetics and Genomics, Mayo Clinic, Rochester, MN, 55905, USA
| | - Ruifeng Ray Guo
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, 32224, USA.
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Płatkowska A, Słowińska M, Zalewska J, Swacha Z, Szumera-Ciećkiewicz A, Wągrodzki M, Patera J, Łapieńska-Rey K, Lorent M, Ługowska I, Rutkowski P, Owczarek W. Minimally Invasive Plasma Device Management of Multiple Benign Skin Cancers Associated with Rare Genodermatoses-Case Series and Review of the Therapeutic Methods. J Clin Med 2024; 13:4377. [PMID: 39124644 PMCID: PMC11312861 DOI: 10.3390/jcm13154377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/22/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024] Open
Abstract
Background: Non-melanocytic benign skin tumours encompass a diverse group of lesions, classified based on their cellular origin, such as epidermal, vascular, fibrous, neural, muscle, and adnexal tumours. Though they often reveal solitary lesions, multiple skin tumours focus on genodermatoses. Each syndrome exhibits distinct clinical characteristics and potential complications, including cutaneous and extra-cutaneous malignancies, some of which are potentially life-threatening. Diagnosing genetic syndromes is complex and requires numerous histopathological and immunohistochemistry tests due to similarities between the adnexal tumours and basal cell carcinoma upon pathology. Methods: To illustrate the clinical practice, we conducted a retrospective case study that included eleven patients with genodermatoses referred to a tertiary dermatology clinic from September 2018 to April 2024. We have also conducted a research study on available treatment modalities in this setting. Results: Five patients with excellent aesthetic results were treated using a recently approved FDA plasma device. After searching SCOPUS and PubMed database records, we assessed 96 original articles to present current knowledge regarding the dermato-surgical approach. Conclusions: Multiple skin tumours, especially on the face, may significantly affect patients' quality of life and have psychological consequences. An appropriate treatment selection tailored to the patient's needs should be provided. There is no standardised treatment for multiple benign tumours in genodermatoses, and selected methods with varying efficacy are employed. We presented the utility of a new plasma device in these settings.
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Affiliation(s)
- Anna Płatkowska
- Department of Dermatology, Military Institute of Medicine—National Research Institute, Central Clinical Hospital Ministry of Defense, Szaserow 128, 04-141 Warsaw, Poland; (A.P.); (J.Z.); (Z.S.); (W.O.)
- Anclara Health & Aesthetic lek. Anna Płatkowska, Anclara Ltd., Puławska 136/62, 02-511 Warsaw, Poland
| | - Monika Słowińska
- Department of Dermatology, Military Institute of Medicine—National Research Institute, Central Clinical Hospital Ministry of Defense, Szaserow 128, 04-141 Warsaw, Poland; (A.P.); (J.Z.); (Z.S.); (W.O.)
| | - Joanna Zalewska
- Department of Dermatology, Military Institute of Medicine—National Research Institute, Central Clinical Hospital Ministry of Defense, Szaserow 128, 04-141 Warsaw, Poland; (A.P.); (J.Z.); (Z.S.); (W.O.)
| | - Zbigniew Swacha
- Department of Dermatology, Military Institute of Medicine—National Research Institute, Central Clinical Hospital Ministry of Defense, Szaserow 128, 04-141 Warsaw, Poland; (A.P.); (J.Z.); (Z.S.); (W.O.)
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland; (A.S.-C.); (M.W.)
- Biobank, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, 00-001 Warsaw, Poland
| | - Michał Wągrodzki
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland; (A.S.-C.); (M.W.)
| | - Janusz Patera
- Department of Pathology, Military Institute of Medicine—National Research Institute, Central Clinical Hospital Ministry of Defense, Szaserow 128, 04-141 Warsaw, Poland; (J.P.); (K.Ł.-R.)
| | - Katarzyna Łapieńska-Rey
- Department of Pathology, Military Institute of Medicine—National Research Institute, Central Clinical Hospital Ministry of Defense, Szaserow 128, 04-141 Warsaw, Poland; (J.P.); (K.Ł.-R.)
| | - Małgorzata Lorent
- Department of Pathology, National Research Institute of Tuberculosis and Lung Diseases, Płocka 26, 01-138 Warsaw, Poland;
| | - Iwona Ługowska
- Department of Soft Tissue, Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, 00-001 Warsaw, Poland; (I.Ł.); (P.R.)
- Early Phase Clinical Trials Unit and Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue, Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, 00-001 Warsaw, Poland; (I.Ł.); (P.R.)
| | - Witold Owczarek
- Department of Dermatology, Military Institute of Medicine—National Research Institute, Central Clinical Hospital Ministry of Defense, Szaserow 128, 04-141 Warsaw, Poland; (A.P.); (J.Z.); (Z.S.); (W.O.)
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McCrary MR, Beekman KE, Strosberg C, Turner L, Sanik E, Beachkofsky TM. A rare case of hidradenocarcinoma with anaplastic and invasive features arising from a nodulocystic hidradenoma. J Cutan Pathol 2024. [PMID: 39022841 DOI: 10.1111/cup.14686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 06/01/2024] [Accepted: 07/01/2024] [Indexed: 07/20/2024]
Abstract
A 91-year-old man presented with a cutaneous left abdominal mass. The mass was longstanding (over 5 years) and slow-growing. Examination revealed a violaceous, multinodular, and exophytic non-tender mass surrounded by patchy erythema. Excisional biopsy was performed and revealed a nodular and cystic dermal proliferation of predominately basaloid cells with focal duct formation, surrounded by prominent hyalinized stroma. The superficial portion of the mass was identified as a nodulocystic hidradenoma. Along the deep aspect and in association with the benign hidradenoma, sheets of markedly atypical epithelioid cells invaded the surrounding tissue, consistent with malignant transformation. Perineural and lymphovascular invasion were seen among areas with anaplastic features. This case supports that some hidradenocarcinoma originates from benign counterparts, and as such, ample sampling is required to definitively exclude a more sinister diagnosis. Diagnostic, prognostic, histopathological, and molecular characteristics, and current knowledge limitations are briefly discussed.
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Affiliation(s)
- Myles R McCrary
- Anatomic and Clinical Pathology, USF Health Morsani College of Medicine, Tampa, Florida, USA
| | - Kate E Beekman
- USF Health Morsani College of Medicine, Tampa, Florida, USA
| | - Carolina Strosberg
- Anatomic and Clinical Pathology, James A. Haley Veterans' Hospital, Tampa, Florida, USA
| | - Leslie Turner
- Anatomic and Clinical Pathology, James A. Haley Veterans' Hospital, Tampa, Florida, USA
| | - Eugene Sanik
- Department of Dermatology, James A. Haley Veterans Hospital, Tampa, Florida, USA
| | - Thomas M Beachkofsky
- Department of Dermatology, James A. Haley Veterans Hospital, Tampa, Florida, USA
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Park L, Wong J. A Case of Digital Papillary Carcinoma Arising on the Toe in a Young Female. Cureus 2024; 16:e63776. [PMID: 39100066 PMCID: PMC11296958 DOI: 10.7759/cureus.63776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/03/2024] [Indexed: 08/06/2024] Open
Abstract
Syringocystadenoma papilliferum is a rare benign adnexal hamartoma that is often associated with the nevus sebaceous of Jadassohn. It usually presents on the scalp and malignant transformation is rare. Here we present a case of digital papillary carcinoma on the toe of a teenage girl. The lesion recurred after two prior excisions without biopsy. The biopsy was read as a syringocystadenoma papilliferum with concerns for aggressive digital papillary adenocarcinoma, highlighting the importance of biopsy with excisions of neoplasms of unknown etiology.
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Affiliation(s)
- Lily Park
- Dermatology, Larkin Community Hospital, Miami, USA
- Department of Dermatology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
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Goto K, Kervarrec T, Tallet A, Macagno N, Pissaloux D, Fouchardière ADL, Battistella M, Kajiwara M, Nagao T, Fujita I, Kajimoto K, Goto H, Matsumura H, Takai T. Hidrocystoma-like tumours with RET or ALK fusion: a study of four cases. Pathology 2024:S0031-3025(24)00166-1. [PMID: 39009490 DOI: 10.1016/j.pathol.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/11/2024] [Accepted: 04/11/2024] [Indexed: 07/17/2024]
Abstract
Hidrocystoma is thought to be a benign retention cyst of sweat ductal units. The lesion is usually located in the periorbital skin; however, lesions with similar histopathological features are rarely observed in extra-facial sites. Herein, we present four cases of hidrocystoma-like tumours in extra-facial skin sites that harboured a RET or ALK rearrangement. This study features a 67-year-old female with a 10 mm-sized digital tumour (Case 1), a 62-year-old male with an 8 mm-sized clavicular tumour (Case 2), a 61-year-old male with a 19 mm-sized digital tumour (Case 3), and an 11-year-old female with a 10 mm-size lower leg tumour (Case 4) as well as five control cases (Cases 5-9) of classical periorbital hidrocystoma. In Cases 1-4, multicystic tumours comprising a two-cell layer of inner cuboidal ductoglandular (p63- and SOX10+/-) and outer flat myoepithelial (p63+ and SOX10+) cells were observed. The inner ductoglandular tumour cells exhibited micropapillary projections and Roman bridging structures. No apparent atypical cells were observed. NCOA4::RET in Cases 1 and 3, CCDC6::RET in Case 2, and SLC12A2::ALK in Case 4 were revealed by next-generation sequencing or Sanger sequencing. In contrast, control cases of classical hidrocystoma (Cases 5-9) did not show intracystic proliferation, abundant cytoplasm, ALK immunoreactivity, or NCOA4::RET detection in the tumour cells. RET/ALK-rearranged hidrocystoma-like tumours are tumour entities that can be distinguished from classical hidrocystoma. This RET/ALK-rearranged neoplasm is benign and is frequently observed in the digits. Future studies will establish the concept, detailed clinicopathological characteristics, and genetic variations of hidrocystoma-like tumours.
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Affiliation(s)
- Keisuke Goto
- Department of Dermatology, Hyogo Cancer Center, Akashi, Japan; Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan; Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan; Department of Pathology, Itabashi Central Clinical Laboratory, Tokyo, Japan; Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan; Department of Diagnostic Pathology, Chutoen General Medical Center, Kakegawa, Japan; Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan; Department of Diagnostic Pathology, Osaka National Hospital, Osaka, Japan; Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan.
| | - Thibault Kervarrec
- Department of Pathology, University Hospital of Tours, Tours, France; 'Biologie des Infections à Polyomavirus' Team, UMR1282 INRAE, University of Tours, Tours, France
| | - Anne Tallet
- Platform of Somatic Tumor Molecular Genetics, CHU of Tours, University of Tours, Tours, France
| | - Nicolas Macagno
- Department of Pathology, APHM, Timone University Hospital, Marseille, France; Aix-Marseille University, INSERM U1251, MMG, Marseille, France
| | - Daniel Pissaloux
- Department of Biopathology, UNICANCER, Léon Bérard Center, Lyon, France; INSERM 1052, CNRS 5286, Cancer Research Center of Lyon, Lyon University, Lyon, France
| | - Arnaud de la Fouchardière
- Department of Biopathology, UNICANCER, Léon Bérard Center, Lyon, France; INSERM 1052, CNRS 5286, Cancer Research Center of Lyon, Lyon University, Lyon, France
| | - Maxime Battistella
- Department of Pathology, APHP Hôpital Saint Louis, Université Paris Cité, Paris, France; INSERM, U976 HIPI, Saint-Louis Research Institute, Paris, France
| | - Manami Kajiwara
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Ikuo Fujita
- Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | - Hiroshi Goto
- Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan
| | - Hajime Matsumura
- Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan
| | - Toshihiro Takai
- Department of Dermatology, Hyogo Cancer Center, Akashi, Japan
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Kervarrec T, Battistella M, Macagno N. [Cutaneous adnexal tumours: Development and synthesis of diagnostic fusion genes]. Ann Pathol 2024:S0242-6498(24)00118-4. [PMID: 38839526 DOI: 10.1016/j.annpat.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 06/07/2024]
Abstract
Cutaneous adnexal tumours are a heterogeneous group of epithelial lesions that includes tumours with follicular, sudoral and/or sebaceous differentiation, or even several combined lines of differentiation. Over the last few years, molecular analysis of these lesions has allowed to identify specific molecular events responsible for tumour development in an increasing number of tumour types. Like other rare neoplasms, such as soft tissue tumours, adnexal tumours display fusion genes resulting from chromosomal translocations that may be specific for the diagnosis if molecular data are properly integrated in the clinical and morphological setting. Molecular testing of adnexal tumours is valuable as it allows to strengthen the robustness of the diagnosis for a group of tumours displaying a wide morphological spectrum. It has allowed to refine the diagnostic criteria and to develop increasingly specific diagnostic immunostainings. Finally, molecular testing has been responsible for the identification of new entities or morphological subtypes of previously known entities. The aim of this review is to provide an update on cutaneous adnexal tumours associated with fusion genes and to evaluate the impact of molecular data on the diagnosis of these lesions.
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Affiliation(s)
- Thibault Kervarrec
- Department of Pathology, université de Tours, hôpital Trousseau, CHRU de Tours, 37044 Tours, France; « Biologie des infections à polyomavirus » team, UMR Inra ISP 1282, université de Tours, Tours, France; CARADERM Network, Lille, France.
| | - Maxime Battistella
- CARADERM Network, Lille, France; Department of Pathology, hôpital Saint-Louis, université Paris 7, AP-HP, Paris, France
| | - Nicolas Macagno
- CARADERM Network, Lille, France; Department of Pathology, Timone University Hospital, Marseille, France
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Schembri-Wismayer D, Gupta S, Erickson LA. Cutaneous Adenoid Cystic Carcinoma. Mayo Clin Proc 2024; 99:1017-1018. [PMID: 38839182 DOI: 10.1016/j.mayocp.2024.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 06/07/2024]
Affiliation(s)
| | - Sounak Gupta
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Lori A Erickson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
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Kervarrec T, Westphal D, Pissaloux D, Legrand M, Tirode F, Neuhart A, Drouot F, Becker JC, Macagno N, Seris A, Jouary T, Beltzung F, Jullie ML, Harms PW, Cribier B, Mourah S, Jouenne F, Fromont G, Louveau B, Mancini M, Kazakov DV, de la Fouchardière A, Battistella M. Porocarcinomas with PAK1/2/3 fusions: a series of 12 cases. Histopathology 2024. [PMID: 38785043 DOI: 10.1111/his.15214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 04/16/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024]
Abstract
AIMS Porocarcinoma is a malignant sweat gland tumour differentiated toward the upper part of the sweat duct and may arise from the transformation of a preexisting benign poroma. In 2019, Sekine et al. demonstrated the presence of YAP1::MAML2 and YAP1::NUTM1 fusions in most poromas and porocarcinomas. Recently, our group identified PAK2-fusions in a subset of benign poromas. Herein we report a series of 12 porocarcinoma cases harbouring PAK1/2/3 fusions. METHODS AND RESULTS Five patients were male and the median age was 79 years (ranges: 59-95). Tumours were located on the trunk (n = 7), on the thigh (n = 3), neck (n = 1), or groin area (n = 1). Four patients developed distant metastases. Microscopically, seven cases harboured a benign poroma component and a malignant invasive part. Ductal formations were observed in all, while infundibular/horn cysts and cells with vacuolated cytoplasm were detected in seven and six tumours, respectively. In three cases, the invasive component consisted of a proliferation of elongated cells, some of which formed pseudovascular spaces, whereas the others harboured a predominant solid or trabecular growth pattern. Immunohistochemical staining for CEA and EMA confirmed the presence of ducts. Focal androgen receptor expression was detected in three specimens. Whole RNA sequencing evidenced LAMTOR1::PAK1 (n = 2), ZDHHC5::PAK1 (n = 2), DLG1::PAK2, CTDSP1::PAK1, CTNND1::PAK1, SSR1::PAK3, CTNNA1::PAK2, RNF13::PAK2, ROBO1::PAK2, and CD47::PAK2. Activating mutation of HRAS (G13V, n = 3, G13R, n = 1, Q61L, n = 2) was present in six cases. CONCLUSION Our study suggests that PAK1/2/3 fusions is the oncogenic driver of a subset of porocarcinomas lacking YAP1 rearrangement.
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Affiliation(s)
- Thibault Kervarrec
- Department of Pathology, Centre Hospitalier Universitaire de Tours, Université de Tours, Tours, France
- "Biologie des infections à polyomavirus" Team, UMR INRA ISP 1282, Université de Tours, Tours, France
- CARADERM Network
| | - Danna Westphal
- National Center for Tumour Diseases (NCT), Partner Site Dresden, Dresden, Germany
- Department of Dermatology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Daniel Pissaloux
- Department of Biopathology, Center Léon Bérard, Lyon, France
- Cancer Research Center of Lyon, Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Equipe Labellisée Ligue contre le Cancer, Lyon, France
| | - Mélanie Legrand
- Department of Pathology, Centre Hospitalier Universitaire de Tours, Université de Tours, Tours, France
| | - Franck Tirode
- Department of Biopathology, Center Léon Bérard, Lyon, France
- Cancer Research Center of Lyon, Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Equipe Labellisée Ligue contre le Cancer, Lyon, France
| | - Anne Neuhart
- Department of Biopathology, Center Léon Bérard, Lyon, France
- Cancer Research Center of Lyon, Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Equipe Labellisée Ligue contre le Cancer, Lyon, France
| | | | - Jürgen C Becker
- Department of Translational Skin Cancer Research, University Hospital Essen, Essen, Germany
- Department of Dermatology, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Pa German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nicolas Macagno
- CARADERM Network
- Department of Pathology, Timone University Hospital, Marseille, France
| | - Alice Seris
- CARADERM Network
- Service de Dermatologie, Centre hospitalier de Pau, Pau, France
| | - Thomas Jouary
- CARADERM Network
- Service de Dermatologie, Centre hospitalier de Pau, Pau, France
| | - Fanny Beltzung
- Department of Pathology, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - Marie-Laure Jullie
- CARADERM Network
- Department of Pathology, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - Paul W Harms
- Department of Pathology, Michigan Medicine/University of Michigan, Ann Arbor, MI, USA
- Department of Dermatology, Michigan Medicine/University of Michigan, Ann Arbor, MI, USA
| | - Bernard Cribier
- Dermatology Clinic, Hopitaux Universitaires & Université de Strasbourg, Hopital Civil, Strasbourg, France
| | - Samia Mourah
- Department of Pharmacology and Solid Tumor Genomics, Saint Louis Hospital, Paris University, AP-HP, Paris, France
| | - Fanélie Jouenne
- Department of Pharmacology and Solid Tumor Genomics, Saint Louis Hospital, Paris University, AP-HP, Paris, France
| | - Gaelle Fromont
- Department of Pathology, Centre Hospitalier Universitaire de Tours, Université de Tours, Tours, France
| | - Baptiste Louveau
- Department of Pharmacology and Solid Tumor Genomics, Saint Louis Hospital, Paris University, AP-HP, Paris, France
| | - Maxence Mancini
- Department of Pharmacology and Solid Tumor Genomics, Saint Louis Hospital, Paris University, AP-HP, Paris, France
| | - Dmitry V Kazakov
- IDP Dermatohistopathologie Institut, Pathologie Institut Enge, Zurich, Switzerland
| | - Arnaud de la Fouchardière
- CARADERM Network
- National Center for Tumour Diseases (NCT), Partner Site Dresden, Dresden, Germany
- Department of Dermatology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Maxime Battistella
- CARADERM Network
- Department of Pathology, APHP Hôpital Saint Louis, INSERM U976, Université Paris Cité7, Paris, France
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9
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Macagno N, Kervarrec T, Thanguturi S, Sohier P, Pissaloux D, Mescam L, Jullie ML, Frouin E, Osio A, Faisant M, Le Loarer F, Cribier B, Calonje E, Luna EVE, Massi D, Goto K, Nishida H, Paindavoine S, Houlier A, Tantot J, Benzerdjeb N, Tirode F, De la Fouchardière A, Battistella M. SOX10-Internal Tandem Duplications and PLAG1 or HMGA2 Fusions Segregate Eccrine-Type and Apocrine-Type Cutaneous Mixed Tumors. Mod Pathol 2024; 37:100430. [PMID: 38266920 DOI: 10.1016/j.modpat.2024.100430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 12/26/2023] [Accepted: 01/16/2024] [Indexed: 01/26/2024]
Abstract
Cutaneous mixed tumors exhibit a wide morphologic diversity and are currently classified into apocrine and eccrine types based on their morphologic differentiation. Some cases of apocrine-type cutaneous mixed tumors (ACMT), namely, hyaline cell-rich apocrine cutaneous mixed tumors (HCR-ACMT) show a prominent or exclusive plasmacytoid myoepithelial component. Although recurrent fusions of PLAG1 have been observed in ACMT, the oncogenic driver of eccrine-type cutaneous mixed tumors (ECMT) is still unknown. The aim of the study was to provide a comprehensive morphologic, immunohistochemical, and molecular characterization of these tumors. Forty-one cases were included in this study: 28 cases of ACMT/HCR-ACMT and 13 cases of ECMT. After morphologic and immunohistochemical characterization, all specimens were analyzed by RNA sequencing. By immunohistochemistry, all cases showed expression of SOX10, but only ACMT/HCR-ACMT showed expression of PLAG1 and HMGA2. RNA sequencing confirmed the presence of recurrent fusion of PLAG1 or HMGA2 in all cases of ACMT/HCR-ACMT, with a perfect correlation with PLAG1/HMGA2 immunohistochemical status, and revealed internal tandem duplications of SOX10 (SOX10-ITD) in all cases of ECMT. Although TRPS1::PLAG1 was the most frequent fusion, HMGA2::WIF1 and HMGA2::NFIB were detected in ACMT cases. Clustering analysis based on gene expression profiling of 110 tumors, including numerous histotypes, showed that ECMT formed a distinct group compared with all other tumors. ACMT, HCR-ACMT, and salivary gland pleomorphic adenoma clustered together, whereas myoepithelioma with fusions of EWSR1, FUS, PBX1, PBX3, POU5F1, and KLF17 formed another cluster. Follow-up showed no evidence of disease in 23 cases across all 3 tumor types. In conclusion, our study demonstrated for the first time SOX10-ITD in ECMT and HMGA2 fusions in ACMT and further refined the prevalence of PLAG1 fusions in ACMT. Clustering analyses revealed the transcriptomic distance between these different tumors, especially in the heterogenous group of myoepitheliomas.
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Affiliation(s)
- Nicolas Macagno
- CARADERM, French Network of Rare Skin Cancers, Lille, France; Department of Pathology, APHM, Timone, Marseille, France; Aix Marseille University, INSERM, MMG, Marseille, France.
| | - Thibault Kervarrec
- CARADERM, French Network of Rare Skin Cancers, Lille, France; Department of Pathology, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France; "Biologie des infections à polyomavirus" team, UMR INRA ISP 1282, Université de Tours, Tours, France
| | | | - Pierre Sohier
- Department of Pathology, Hôpital Cochin, AP-HP. Centre-Université Paris Cité, Paris, France
| | - Daniel Pissaloux
- Department of Biopathology, Centre Léon Bérard, Lyon, France; Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Equipe Labellisée Ligue contre le Cancer, Lyon, France
| | - Lenaïg Mescam
- Department of Biopathology, Paoli-Calmettes Institute, Marseille, France
| | - Marie-Laure Jullie
- Department of Pathology, University Hospital of Bordeaux, Bordeaux, France
| | - Eric Frouin
- Department of Pathology, University Hospital of Poitiers, University of Poitiers, LITEC, Poitiers, France
| | - Amelie Osio
- National Center of Dermatopathology, Paris-la Roquette, Ivry, France; Department of Pathology, HCL Lyon-Sud Hospital, Lyon, France
| | | | - François Le Loarer
- Department of Biopathology, Bergonié Institute, Bordeaux, France; Bordeaux Institute of Oncology, BRIC U1312, INSERM, Université de Bordeaux, Institut Bergonié, Bordeaux, France
| | - Bernard Cribier
- Department of Dermatology, University of Strasbourg, Strasbourg, France
| | - Eduardo Calonje
- Department of Dermatopathology, St John's institute of Dermatology, Guy's and St Thomas' NHS trust, London, United Kingdom
| | - Evelyn Vanesa Erazo Luna
- Department of Dermatopathology, St John's institute of Dermatology, Guy's and St Thomas' NHS trust, London, United Kingdom
| | - Daniela Massi
- Section of Pathology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Keisuke Goto
- Department of Diagnostic Pathology, Faculty of Medicine, Oita, Japan
| | - Haruto Nishida
- Department of Diagnostic Pathology, Faculty of Medicine, Oita, Japan
| | | | - Aurelie Houlier
- Department of Biopathology, Centre Léon Bérard, Lyon, France
| | - Juliet Tantot
- Department of Pathology, HCL Lyon-Sud Hospital, Lyon, France
| | | | - Franck Tirode
- Department of Biopathology, Centre Léon Bérard, Lyon, France; Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Equipe Labellisée Ligue contre le Cancer, Lyon, France
| | - Arnaud De la Fouchardière
- Department of Biopathology, Centre Léon Bérard, Lyon, France; Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Equipe Labellisée Ligue contre le Cancer, Lyon, France
| | - Maxime Battistella
- CARADERM, French Network of Rare Skin Cancers, Lille, France; Department of Pathology, AP-HP Hospital Saint-Louis, INSERM U976, Université Paris Cité, Paris, France
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10
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Shaker N, Vohra P, Li Z, Sangueza OP, Abid A. Cutaneous eccrine spiradenoma: Insights into cytomorphological features via fine needle aspiration biopsy and a comprehensive literature review. Cytopathology 2024; 35:301-306. [PMID: 38084507 DOI: 10.1111/cyt.13348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 02/07/2024]
Abstract
Eccrine spiradenoma (ES) is an uncommon and benign adnexal tumour originating from sweat glands. The cytological examination of ES poses a diagnostic challenge, as it can be mistaken for various benign and malignant basaloid skin neoplasms. The cytomorphologic features of ES are infrequently documented in existing literature. This study seeks to present a thorough exploration of the cytomorphologic traits associated with ES, accompanied by an analysis of ancillary testing that contribute to the accurate identification of this entity in cytological specimens.Eccrine spiradenoma is infrequently encountered in fine needle aspiration (FNA) cytopathology, and the available literature on its cytomorphologic features is limited. The challenge arises from its similarity to other benign and malignant dermal basaloid neoplasms, emphasizing the critical role of clinicopathologic correlation and immunohistochemical staining in achieving a precise diagnosis.
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Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Poonam Vohra
- Department of Pathology, University of California San Francisco, San Francisco, California, USA
| | - Zaibo Li
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Omar P Sangueza
- Departments of Dermatology and Pathology, School of Medicine, Medical Center Boulevard, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Abdul Abid
- Department of Pathology, University of Virginia Health, Charlottesville, Virginia, USA
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11
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Valentini R, Khan A, Murphy M, Sloan B. Violaceous lunula with pigmented longitudinal ridge. JAAD Case Rep 2024; 44:38-40. [PMID: 38292577 PMCID: PMC10824697 DOI: 10.1016/j.jdcr.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Affiliation(s)
- Rodolfo Valentini
- University of Connecticut School of Medicine, Farmington, Connecticut
| | - Aziz Khan
- Department of Dermatology, UConn, Farmington, Connecticut
| | - Michael Murphy
- Department of Dermatology, UConn, Farmington, Connecticut
| | - Brett Sloan
- Department of Dermatology, UConn, Farmington, Connecticut
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12
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Sağnıç S, Ay SS, Tuncer HA, Doğan S, Şimşek T. Hidradenoma papilliferum of the perineum; a rare tumour in a rare location. J OBSTET GYNAECOL 2023; 43:2186781. [PMID: 36912189 DOI: 10.1080/01443615.2023.2186781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Affiliation(s)
- Saliha Sağnıç
- Department of Gynecology Obstetrics, Division of Gynecologic Oncology, Akdeniz University, Antalya, Turkey
| | - Sinan Serdar Ay
- Department of Gynecology Obstetrics, Division of Gynecologic Oncology, Akdeniz University, Antalya, Turkey
| | - Hasan Aykut Tuncer
- Department of Gynecology Obstetrics, Division of Gynecologic Oncology, Akdeniz University, Antalya, Turkey
| | - Selen Doğan
- Department of Gynecology Obstetrics, Division of Gynecologic Oncology, Akdeniz University, Antalya, Turkey
| | - Tayup Şimşek
- Department of Gynecology Obstetrics, Division of Gynecologic Oncology, Akdeniz University, Antalya, Turkey
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13
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Bogiatzi S, Estenaga A, Louveau B, Osio A, Deschamps L, Mourah S, Poirot B, Lehmann-Che J, Cribier B, Battistella M. Microsecretory adenocarcinoma of the skin, a novel type of sweat gland carcinoma: Report of three additional cases. J Cutan Pathol 2023; 50:897-902. [PMID: 36790018 DOI: 10.1111/cup.14408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023]
Abstract
Microsecretory adenocarcinoma (MSA) is a newly described salivary gland tumor harboring a characteristic balanced chromosomal translocation resulting in MEF2C::SS18 gene fusion. Six primary cutaneous MSA cases have been recently described. We report three additional cases confirming the relevance of this recently identified entity of primary cutaneous adnexal tumor. Three patients aged 53-, 64- and 78-year-old were retrospectively diagnosed with MSA of the skin (MSAS) as consultation cases of the CARADERM (CAncers RAres DERMatologiques) national network. The clinical presentation was an indolent nodule on the upper extremities. There was no history of salivary gland tumor. Histopathologically, the tumors presented as dermal nodular proliferation with slightly infiltrative borders, composed of cribriform and microcystic structures with abundant myxoid intraluminal secretion embedded in a fibromyxoid stroma. They diffusely expressed cytokeratin 8 and SOX10, focally p63 and heterogeneously smooth muscle actin. All tumors harbored the MEF2C::SS18 gene fusion. A complete surgical excision was performed. No local recurrence or distant metastases were observed so far (follow-up: 17, 38, and 45 months). MSAS is the cutaneous homologue of MSA of the salivary gland, a low-grade adnexal neoplasm whose prognosis seems to be excellent once the complete removal of the tumor is assured.
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Affiliation(s)
- Sofia Bogiatzi
- Pathology Department, Saint-Louis Hospital, Paris, France
| | | | - Baptiste Louveau
- Solid Tumor Genomics Department, Saint-Louis Hospital, Paris, France
| | - Amélie Osio
- Pathology Department, Saint-Louis Hospital, Paris, France
| | | | - Samia Mourah
- Solid Tumor Genomics Department, Saint-Louis Hospital, Paris, France
- Université Paris Cité, Paris, France
- INSERM U976, Paris, France
| | - Brigitte Poirot
- Solid Tumor Genomics Department, Saint-Louis Hospital, Paris, France
| | - Jacqueline Lehmann-Che
- Solid Tumor Genomics Department, Saint-Louis Hospital, Paris, France
- Université Paris Cité, Paris, France
- INSERM U976, Paris, France
| | - Bernard Cribier
- Dermatopathology Unit, Clinique Dermatologique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Maxime Battistella
- Pathology Department, Saint-Louis Hospital, Paris, France
- Université Paris Cité, Paris, France
- INSERM U976, Paris, France
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14
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Rathore R, Aggarwal D, Tanveer N, Sharma S. Cytohistological and Immunohistochemical Correlation of Cutaneous Mixed Tumors: A Series of Four Cases and Review of Recent Molecular Updates. Cureus 2023; 15:e47233. [PMID: 38021919 PMCID: PMC10654049 DOI: 10.7759/cureus.47233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Fine needle aspiration cytology (FNAC) is an established diagnostic modality today, but its utilization in skin tumors is limited by the fact that most of these lesions are small and easily accessible for clinicians to perform an excision biopsy. As a result, our knowledge of the cytological features of some of the uncommonly encountered skin tumors is still lacking. The aim of this study was to correlate the cytological features of cutaneous mixed tumors (CMTs) with histological and immunohistochemical findings in four cases of CMT in commonly and uncommonly encountered locations. We also review the recent updates highlighting the various genetic rearrangements and newer more specific immunohistochemical markers described so far. This was a retrospective study, and all the slides were taken from our departmental archives. Case 1 was a 25-year-old male who presented with a gradually increasing painless swelling over the right angle of the mouth of 1.5 years duration. Case 2 was a 45-year-old male with swelling on the right forearm for the last three years. Case 3 was a 35-year-old female with a forehead swelling of one year duration. Case 4 was a 55-year-old female with left cheek swelling for two years. On clinical examination, all four nodular swellings were predominantly in the skin/subcutaneous tissue. On cytology, all cases showed abundant chondromyxoid material with clusters of benign epithelial cells and a fair number of predominantly singly scattered myoepithelial cells. The diagnosis of all four cases was further confirmed on histopathology and immunohistochemistry, and the findings correlated well with cytology. The cytological features of CMT closely correlate with their histopathological and immunohistochemical features. Newer immunohistochemistry (IHC) marker pleomorphic adenoma gene 1 (PLAG1) may be helpful in making a definitive diagnosis of CMT on cytology and cell block preparation along with a good clinical correlation. Complete surgical excision is the treatment of choice, and recurrence is rare.
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Affiliation(s)
- Ruchi Rathore
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, IND
| | - Divya Aggarwal
- Department of Pathology, All India Institute of Medical Sciences, Jodhpur, IND
| | - Nadeem Tanveer
- Department of Pathology, University College of Medical Sciences, Delhi, IND
| | - Sonal Sharma
- Department of Pathology, University College of Medical Sciences, Delhi, IND
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15
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Kyriakopoulos AM, Nigh G, McCullough PA, Olivier MD, Seneff S. Bell's palsy or an aggressive infiltrating basaloid carcinoma post-mRNA vaccination for COVID-19? A case report and review of the literature. EXCLI JOURNAL 2023; 22:992-1011. [PMID: 37927346 PMCID: PMC10620857 DOI: 10.17179/excli2023-6145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/15/2023] [Indexed: 11/07/2023]
Abstract
We report on an aggressive, infiltrating, metastatic, and ultimately lethal basaloid type of carcinoma arising shortly after an mRNA vaccination for COVID-19. The wife of the patient, since deceased, gave the consent for publishing the case. The malignancy was of cutaneous origin and the case showed symptoms consistent with Bell's palsy and trigeminal neuralgia beginning four days post-vaccination (right side head temporal pain). The temporal pain was suggestive for inflammation and impairment of T cell immune activation. Magnetic Resonance Imaging (MRI) showed a vascular loop on the left lateral aspect of the 5th cranial root exit of cerebellopontine angle constituting presumably a normal variant and was considered as an unrelated factor to the right-sided palsy and pain symptoms that corresponded to cranial nerves V (trigeminal nerve) and VII (facial nerve). In this study we describe all aspects of this case and discuss possible causal links between the rapid emergence of this metastatic cancer and mRNA vaccination. We place this within the context of multiple immune impairments potentially related to the mRNA injections that would be expected to potentiate more aggressive presentation and progression of cancer. The type of malignancy we describe suggests a population risk for occurrence of a large variety of relatively common basaloid phenotype cancer cells, which may have the potential for metastatic disease. This can be avoidable with early diagnosis and adequate treatment. Since facial paralysis/pain is one of the more common adverse neurological events following mRNA injection, careful inspection of cutaneous/soft tissue should be conducted to rule out malignancy. An extensive literature review is carried out, in order to elucidate the toxicity of mRNA vaccination that may have led to the death of this patient. Preventive and precise routine clinical investigations can potentially avoid future mortalities. See also Figure 1(Fig. 1).
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Affiliation(s)
- Anthony M. Kyriakopoulos
- Director and Head of Research and Development, Nasco AD Biotechnology Laboratory, Department of Research and Development, Sachtouri 11, 18536, Piraeus, Greece
| | - Greg Nigh
- Naturopathic Oncologist, Immersion Health, Portland, OR 97214, USA
| | | | - Maria D. Olivier
- Director and medical practitioner, Dr. Maré Olivier, Inc., Kuils River, South Africa
| | - Stephanie Seneff
- Senior Research Scientist, Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA
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16
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Joshy J, van Bodegraven B, Mistry K, Craig P, Rajan N, Vernon S, Levell NJ, Venables ZC. Epidemiology of porocarcinoma in England 2013-2018: a population-based registry study. Clin Exp Dermatol 2023; 48:770-777. [PMID: 37002829 DOI: 10.1093/ced/llad122] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/26/2023] [Accepted: 03/27/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Porocarcinoma (PC) is a cutaneous malignancy that differentiates towards (possibly arises from) the sweat ducts and glands. Lack of histological diagnostic markers makes clinical and pathological diagnosis complex. The limited data available suggest the incidence is increasing; however, this remains to be established in national epidemiological studies. OBJECTIVES To report the incidence, treatment and survival of patients with PC in England from 1 January 2013 to 31 December 2018 using national cancer registry data. METHODS PC diagnoses in England during 2013-2018 were identified from the National Disease Registration Service using morphology and behaviour codes. These were registered from routinely collected pathology reports and cancer outcomes and services datasets. The 2013 European age standardized incidence rates (EASRs), Kaplan-Meier all-cause survival and log-rank test were calculated. RESULTS In total, 738 tumours (396 in males and 342 in females) were diagnosed. The median age at diagnosis was 82 years old (interquartile range 74-88). The most frequently affected site were lower limbs (35.4%), followed by the face (16%). The majority of the cohort received surgical excision (73.0%). The Kaplan-Meier all-cause survival was 45.4% at 5 years, which was lower than in previous studies. The EASR for the whole population was 0.25 [95% confidence interval (CI) 0.23-0.27] per 100 000 person-years (PY)]. PC incidence rates in the East of England (EASR of 0.54, 95% CI 0.47-0.63 per 100 000 PY) were three times higher than the South West (EASR of 0.14, 95% CI 0.10-0.19 per 100 000 PY) where the regional rates were the lowest. CONCLUSIONS This study shows that there is large variation in the EASRs of PC across England. This may reflect differences in how PC is diagnosed and registered in different regions in England. These data support national assessment of the management of PC, which will inform future studies and guideline development.
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Affiliation(s)
- Jilse Joshy
- University of East Anglia, Norwich Medical School, Norwich, UK
| | - Birgitta van Bodegraven
- British Association of Dermatologists, London, UK
- National Disease Registration Service, Data and Analytics, NHS England, UK
| | - Khaylen Mistry
- University of East Anglia, Norwich Medical School, Norwich, UK
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Dermatology, Norwich, UK
| | - Paul Craig
- Department of Cellular Pathology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Neil Rajan
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Sally Vernon
- National Disease Registration Service, Data and Analytics, NHS England, UK
| | - Nick J Levell
- University of East Anglia, Norwich Medical School, Norwich, UK
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Dermatology, Norwich, UK
| | - Zoe C Venables
- University of East Anglia, Norwich Medical School, Norwich, UK
- National Disease Registration Service, Data and Analytics, NHS England, UK
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Dermatology, Norwich, UK
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17
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Alves DG, Araújo C, Sousa J, Lapa A, Abreu de Sousa J. Hidradenocarcinoma of the Female Breast: A Surgical Approach to a Rare Skin Tumor. Cureus 2023; 15:e42577. [PMID: 37641751 PMCID: PMC10460289 DOI: 10.7759/cureus.42577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 08/31/2023] Open
Abstract
Clear-cell hidradenocarcinomas are extremely uncommon sweat gland tumors with a predilection for the head and neck. In the limited number of articles reporting breast involvement, the primary focus concerns this entity's histological and immunohistochemical characteristics. Since hidradenocarcinomas of the breast have the potential to resemble a primary breast carcinoma closely, diagnosis may be challenging. Therefore, the authors report the first case of hidradenocarcinoma of the breast, which features its macroscopic morphology. In addition, to increase physicians' awareness of this rare neoplasm, the article also aims to detail its surgical approach.
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Affiliation(s)
| | - Cláudia Araújo
- Surgical Oncology, Instituto Português de Oncologia do Porto, Porto, PRT
| | - Jessica Sousa
- Radiology, Centro Hospitalar Universitario do Porto EPE, Porto, PRT
| | - Alexandra Lapa
- Anatomical Pathology, Instituto Português de Oncologia do Porto, Porto, PRT
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18
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Kolm I, Konstantinova AM, Kutzner H, Barghorn A, Vanecek T, Mangana J, Kazakov DV. Cuticular Poroma: A Rare Poroma Variant Simulating a Malignant Neoplasm That Often Harbors YAP1::NUTM1 Fusions Similar to Their Conventional Counterparts. Am J Dermatopathol 2023; Publish Ahead of Print:00000372-990000000-00203. [PMID: 37335840 DOI: 10.1097/dad.0000000000002465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
ABSTRACT Cuticular poroma is a rare variant of poroma composed of exclusively or predominantly cuticular cells, namely of large cells with ample eosinophilic cytoplasm. We report 7 cases of this rare tumor identified among 426 neoplasms diagnosed as poroma or porocarcinoma. The patients were 4 males and 3 females, ranging in age from 18 to 88 years. All presented with a solitary asymptomatic nodule. The location included knee (2 cases), shoulder, thigh, shin, lower arm, and neck (each 1). All lesions were surgically removed. No evidence of disease was observed in 5 patients with available follow-up (range 12-124 months).Microscopically, all neoplasms were composed of variably sized, focally closed packed, or interconnecting nodules constituted mostly of cuticular cells. Small poroid cells were a focal feature in 5 tumors, whereas in the remaining 2 cases, poroid cells with conspicuous but still in minority. Five neoplasms were somewhat asymmetric, with irregular outlines. Ductal differentiation and intracytoplasmic vacuoles were seen in 6 tumors. Other features variably encountered were conspicuous intranuclear pseudoinclusions, cystic change, occasional multinucleated cells, increased mitoses, and stromal desmoplasia. Four of the 5 tumors analyzed with next-generation sequencing yielded YAP1::NUTM1 fusions. In addition, various mutations, mostly of unknown significance were identified in one neoplasm.
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Affiliation(s)
- Isabel Kolm
- Department of Dermatology, University Hospital Zurich, University of Zurich, Switzerland
| | - Anastasia M Konstantinova
- Department of Pathology, Clinical Research and Practical Center for Specialized Oncological Care, Saint-Petersburg, Russia
- Department of Pathology, Saint-Petersburg Medico-Social Institute, Saint-Petersburg, Russia
| | - Heinz Kutzner
- Dermatopathology Laboratory, Friedrichshafen, Germany
| | | | - Tomas Vanecek
- Sikl's Department of Pathology, Medical Faculty in Pilsen, Charles University in Prague, Pilsen, Czech Republic; and
| | - Joanna Mangana
- Department of Dermatology, University Hospital Zurich, University of Zurich, Switzerland
| | - Dmitry V Kazakov
- Department of Dermatology, University Hospital Zurich, University of Zurich, Switzerland
- IDP Institut für Dermatopathohistologie, Pathologie Institut Enge, Zürich, Switzerland
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19
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Wierzbicka M, Kraiński P, Bartochowska A. Challenges in the diagnosis and treatment of the malignant adnexal neoplasms of the head and neck. Curr Opin Otolaryngol Head Neck Surg 2023; 31:134-145. [PMID: 36912226 DOI: 10.1097/moo.0000000000000872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
PURPOSE OF REVIEW The current review is to present the current knowledge regarding epidemiology, diagnostics, and management of malignant adnexal neoplasms (MANs). RECENT FINDINGS Immunotherapy and gene-related therapies are still being developed as the methods of salvage treatment in advanced and disseminated cases: CACNA1S, ATP2A1, RYR1, and MYLK3, as well as p53 or the JAK/STAT pathways, may be therapeutic targets; the efficiency of talimogene laherparepvec and nivolumab is assessed. SUMMARY MANs are rare tumors, but due to the aging of population their incidence is increasing. Their clinical presentation is unspecific, which makes the diagnosis challenging. Histopathological assessment is difficult even for experienced pathologists. Mohs micrographic surgery or wide local excision are recommended to treat primary lesions. Adjuvant radiotherapy may be beneficial in case of insufficient or positive surgical margins, in nodal metastases, in selected types of MANs like sebaceous, trichilemmal, and pilomatrix carcinomas, and as the induction treatment in large tumors located in medically fragile or cosmetically important regions. The role of chemotherapy is not well defined; however, it is recommended in distant metastases. Immunotherapy can improve the prognosis in advanced stage of the disease.
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Affiliation(s)
- Małgorzata Wierzbicka
- Department of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences
- Institute of Human Genetics, Polish Academy of Sciences
| | - Patryk Kraiński
- Department of Clinical Pathology and Immunology, Poznań University of Medical Sciences, Poznań, Poland
| | - Anna Bartochowska
- Department of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences
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20
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Opiła R, Feszak S, Wawryków P, Peregud-Pogorzelski J. Infant with Parotid Sialoblastoma and Nevus Sebaceous, Treated with Surgery and Adjuvant Chemotherapy. CHILDREN 2023; 10:children10040628. [PMID: 37189877 DOI: 10.3390/children10040628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/17/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023]
Abstract
Sialoblastoma is an extremely rare embryonal tumor derived from salivary gland primordial cells. Treatment usually consists of surgery alone; however, in some cases, chemotherapy is required and is administered with good response. We present a case of a 5-week-old girl diagnosed with a parotid gland tumor and co-existing nevus sebaceous on the face. Initial tumorectomy was microscopically non-radical and histopathology revealed sialoblastoma. The patient received adjuvant chemotherapy consisting of vincristine, actinomycin, and cyclophosphamide. Due to imaging studies being inconclusive regarding response and possible residual disease, a second surgery (total parotidectomy) was performed. The histopathology results showed fields of necrosis in the parotid gland but no neoplastic cells in the material. The patient remains under watchful observation and there is no evidence of relapse 12 months after the second surgery. The adjuvant chemotherapy regimen with vincristine, actinomycin, and cyclophosphamide is a viable option of treatment in children with sialoblastoma.
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Rotin DL, Paklina OV, Zakurdaev EI, Tin’kova IO. A rare case of primary adenocarcinoma of the eyelid. HEAD AND NECK TUMORS (HNT) 2022. [DOI: 10.17650/2222-1468-2022-12-3-136-140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction. primary mucinous carcinoma of the eyelid skin is a rare adenocarcinoma of skin glands. This tumor rarely metastasizes but frequently recurs.The study objective is to describe a rare clinical case of primary mucinous carcinoma of the eyelid skin, present macroscopic, histological and immunohistological descriptions of this pathology.Clinical case. male, 66 years old, sought medical care due to a neoplasm of the lower eyelid. macroscopically a subcutaneous node 1.2 × 1.0 cm was observed, of yellow-brown color, gelatinous in section. microscopic examination showed that the tumor consists of islands of epithelial cells surrounded by mucinous “lakes”. Immunohistochemical examination showed Ck7, estrogen, p53 expression in the tumor cells, as well as absence of Ck20 expression. Based on the data of macro-, microscopic and immunohistochemical examinations, primary mucinous carcinoma of the eyelid skin was diagnosed. Observed morphological signs of this tumor allow to differentiate it from cancer metastasis.Conclusion. primary mucinous carcinoma of the skin should be differentiated from metastasis of mucinous carcinoma of the breast, lung, colon, et al. macro- and microscopic signs of this tumor are subjective. Immunohistochemical examination is a more reliable diagnostic tool.
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Affiliation(s)
- D. L. Rotin
- S. P. Botkin Clinical Hospital, Moscow Healthcare Department
| | - O. V. Paklina
- S. P. Botkin Clinical Hospital, Moscow Healthcare Department
| | - E. I. Zakurdaev
- S. P. Botkin Clinical Hospital, Moscow Healthcare Department
| | - I. O. Tin’kova
- S. P. Botkin Clinical Hospital, Moscow Healthcare Department
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22
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Russell-Goldman E, Hanna J. MAML2 Gene Rearrangement Occurs in Nearly All Hidradenomas: A Reappraisal in a Series of 20 Cases. Am J Dermatopathol 2022; 44:806-811. [PMID: 35925563 DOI: 10.1097/dad.0000000000002276] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Hidradenoma is a benign cutaneous adnexal neoplasm that occurs across a wide age range and at a variety of anatomic sites. Its most characteristic morphologic feature is the presence of diverse cell types including squamoid, clear, plasmacytoid, and mucinous cells. Hidradenoma is morphologically and molecularly similar to mucoepidermoid carcinoma, and both tumors are characterized by recurrent CRTC1-MAML2 cytogenetic translocations. Previous studies have suggested that approximately half of hidradenomas possess this translocation. This finding raised the question of whether translocation-negative hidradenomas might have an alternate molecular basis. Here, we sought to reevaluate the frequency of MAML2 translocation in hidradenoma in a series of 20 cases. We find that 90% show evidence of MAML2 translocation, suggesting that this genetic event is a nearly invariant feature of hidradenoma. These results inform our molecular understanding of this tumor and may be useful in challenging cases to distinguish hidradenoma from its histologic mimics.
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Affiliation(s)
- Eleanor Russell-Goldman
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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